Provider Demographics
NPI:1215991161
Name:MCPHERSON, JULITA MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:JULITA
Middle Name:MARIE
Last Name:MCPHERSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:9137 S CLYDE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60617-3741
Mailing Address - Country:US
Mailing Address - Phone:773-768-1686
Mailing Address - Fax:312-572-2769
Practice Address - Street 1:3525 S MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60653-1019
Practice Address - Country:US
Practice Address - Phone:312-945-4010
Practice Address - Fax:312-945-4032
Is Sole Proprietor?:No
Enumeration Date:2006-04-16
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036104513207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine